Journal article
Performance of risk assessment algorithms recommended by the World Falls Guidelines (WFG) to predict fall and fall-related injury among older Chinese community-dwellers
Journal of safety research, Vol.95, pp.338-344
12/2025
DOI: 10.1016/j.jsr.2025.10.018
Abstract
ntroduction: The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022, but its predictive performance was reported only in Ireland, the United States, the Netherlands, Australia, and Malaysia. Methods: Using a nationally representative dataset, the China Health and Retirement Longitudinal Study (CHARLS), we analyzed data from six follow-up cohort visits (2, 3, 4, 5, 7, 9 years). The Cochran-Armitage trend test examined trends in fall and fall-related injury rate across the WFG algorithm. Multivariable logistic regression models examined associations between the WFG algorithm and fall and fall-related injury incidence rates. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and 95% confidence intervals (95% CIs) were calculated to assess predictive performance of the WFG algorithm. Sensitivity analyses were performed to assess the impact of missing values on principal findings. Results: We included 9,735, 5,377, 4,092, 9,426, 7,776, and 3,355 eligible older adults across the six follow-up time periods, with sample sizes varying due to the study’s dynamic recruitment strategy. Fall risk categorized by WFG algorithm was significantly associated with falls and fall-related injuries at all six follow-up cohorts (p < 0.05). However, its predictive performance for both falls and fall-related injuries was unacceptable, with sensitivity ranging from 20.2% to 32.5% for both outcomes across the six follow-up visits. Sensitivity analyses displayed highly similar results. Conclusion: The WFG algorithm is valuable for predicting future falls and fall-related injuries among older Chinese community-dwellers, but its predictive performance is unacceptable for practical use without considering other contributing factors. Practical Applications: Further methodological modifications of the WFG algorithm are recommended to improve its predictive performance.
Details
- Title: Subtitle
- Performance of risk assessment algorithms recommended by the World Falls Guidelines (WFG) to predict fall and fall-related injury among older Chinese community-dwellers
- Creators
- Weiqiang LiMin ZhaoYanhong FuDavid C. SchwebelNa ZhangLei YangJingtao ZhouYouyou WuTongfei ZhangPeishan NingLi LiZhenzhen RaoGuoqing Hu
- Resource Type
- Journal article
- Publication Details
- Journal of safety research, Vol.95, pp.338-344
- DOI
- 10.1016/j.jsr.2025.10.018
- ISSN
- 0022-4375
- eISSN
- 1879-1247
- Publisher
- Elsevier
- Grant note
- National Key Research and Develop-ment Program of China: 2022YFC3603000 National Natural Science Foundation of China: 82561160168
This work was supported by National Key Research and Develop-ment Program of China (No. 2022YFC3603000) and the Funds for In-ternational Cooperation and Exchange of the National Natural Science Foundation of China (No. 82561160168) .
- Language
- English
- Date published
- 12/2025
- Academic Unit
- Research Administration; Psychological and Brain Sciences
- Record Identifier
- 9985017439402771
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